Cyclothymia, “it’s the disease of excess” (Laetitia Payen, mother of a bipolar child)

“At home, Stan was giving us hell.” It is with these words that begins the testimony of Laetitia Payen, mother of two children in her book “My child cyclone”. Her youngest son, Stanislas, suffers from cyclothymia, a still poorly understood bipolar disorder. To support this cause, the professional iconographer became president of the Bicycle association, which helps families whose children and adolescents have mood disorders. She fights for an early diagnosis of mental disorders in children.

It was very complicated from birth. He was a little boy who slept little and cried a lot. We thought it was due to the health concerns he accumulated over the first two years of his life. After she was two years old, the sleep disturbances continued. The gestures of daily life have become impossible. Putting on his coat, going to the table, putting him in the car seat… In Stan, there was an intolerance to frustration that led to crises of terrible intensity. They could last more than an hour and repeat themselves several times a day.

Very quickly, obsessive-compulsive disorders were added. When he went to bed, the slippers had to be perfectly aligned on the floorboards. At the table, he had to be in the same place, the cutlery to be perfectly aligned with his plate.

Added to all this was the hypersensitivity that was causing problems at school. He couldn’t stand loud noises, which caused problems in the canteen. It happened to him not to support the perfume of the mistress for example. On vacation, we went to a eucalyptus candy factory, we had to go out urgently.

He was a little boy who was hot all the time. The heat could cause him seizures, both in class and at home if a fire was lit.

Things got out of hand around four and five years old. I was covered in bruises. At five, he was able to break down his bedroom door, undo the slats of his bed, and throw them down the stairs. When he had his tantrums, we had to contain him so that he didn’t hurt himself, but also so that he didn’t break everything around him. Especially when we weren’t home.

There were two facets and during the crises, he was physically transformed. His eyes were starting to roll, and a hoarse voice, not the same as that of a five-year-old boy. In those moments, we lost him, it was no longer him.

There were also insults, harassment. He could say to me “mum when are you crying, because I like it when you cry”. He said to me “is this your favorite object?” before smashing it against the wall. And lots of little things. For example, he could blow into my ears, make the same noise all the time for 4 hours straight. We were exhausted and there was a feeling of incomprehension. It was terrible.

It took some time to recover. He could tell me “mom, I love you so much that I could go on stage to tell the whole planet”. Everything was too much. It is the disease of excess.

In your book, before the diagnosis, you talk about loneliness, both for you, for your family and for Stan.

We questioned ourselves, we wondered what we had done wrong. However, we had the example of Atsuki, our first daughter with whom everything was going well. But we are not the only ones having difficulties. The school can’t take it anymore, our friends can’t take it anymore, his sister can’t take it anymore. She said to me “When Stan is in crisis, I feel like a ghost“. My husband told me “I feel like I’m losing life points, it’s like I’m dead inside“. There is an exhaustion. We are ashamed. We live in the stress of the next crisis.

In your book you talk about the “hell” you went through. What are the positive signs you were looking for in difficult times?

By dint of exhaustion, we tip over and we come to think that we will no longer love our child. It is the most difficult. We have no solutions. Stanislas was verbalizing, and that helped us. He told us his fears “by dint of having crises, you will no longer love me“. One day, when I was asking her sister what she wanted to do later, I also asked her the question. “I won’t do anything, I’ll kill myself“. Beyond our own suffering, this is what allowed us to hear his. This is what gave us the strength to continue to fight.

We note that Stan was diagnosed thanks to your steps, after numerous misdiagnoses by health professionals.

We were told about attention deficit disorder with or without hyperactivity (ADHD), then autistic disorders, high intellectual potential… But none of them stuck entirely. I spent my nights, my evenings looking for solutions, exploring the internet to find a solution.

Cyclothymia, which is part of the spectrum of bipolar disorder, is misunderstood by many healthcare professionals. Most of the time, there is a problem with the criterion of bipolarity in children. Today, the recognized consensus is based on the diagnostic criteria for adults with typical and caricatural bipolarity formerly called manic depression.

For most doctors, to diagnose bipolar disorder in a child, there must be a “characterized” manic attack. And it is almost never found in children under fifteen. These are different symptoms in children.

What were the stages of care after the diagnosis?

Support is based on three pillars. Behavioral and cognitive therapy teaches how to better manage one’s emotions and identify the triggers of crises. There is psychoeducation, for the parents and the child. This allows you to become an expert in the disorder. The child becomes an actor of his illness. He knows how to adopt a healthy lifestyle, pay attention to his sleep, identify the triggers… The parents learn and understand the disease. This makes it possible to better react to the behavior of the child and to seek out the underlying emotion. This is the base on which the care will weigh.

If necessary, there may be drug therapy, namely a mood stabilizer. Stan had to take it, it allowed him to be receptive to behavioral and cognitive therapy and psychoeducation.

Officially, there is no mood regulator for the child. As in adults, an antiepileptic can be used to control this mood disorder. But in children there is an indication only for epilepsy.

Bipolarity is still poorly recognized and diagnosed in children?

Some doctors are faced with a dogma and do not update their knowledge. Among these doctors, a large part has a psychoanalytical obedience. It’s a double jeopardy for the parents, it’s all about education. Some doctors find that to diagnose a child is to lock him up and put a label on him.

For us, before the diagnosis, we were very closed in. The diagnosis was liberating. Moreover, a diagnosis is not a label, it is the beginning of a solution. It shows a direction to take. The Bicycle association campaigns for mental disorders to be treated in the same way as physical illnesses. That is to say prevention, diagnosis and treatment as quickly as possible.

The differential diagnosis is also one of the reasons. It is a disorder that can be confused with other disorders. At the top, all neurodevelopmental disorders. I am thinking in particular of ADHD, autism spectrum disorders, depression, or particularities such as hypersensitivity and high potential.

Some want to treat the symptoms without making a diagnosis, in the case of bipolarity, this is problematic. If we follow this reasoning, we will give psychostimulants for hyperactivity or antidepressants for depression. These are drugs that will aggravate the disorders.